Maine Revised Statutes Title 24-A Sec. 4320-J – Coverage for abuse-deterrent opioid analgesic drug products
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1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings.
A. “Abuse-deterrent opioid analgesic drug product” means a brand or generic opioid analgesic drug product approved by the federal Food and Drug Administration with abuse-deterrent labeling claims that indicate the drug product is expected to result in a meaningful reduction in abuse. [PL 2015, c. 371, §1 (NEW); PL 2015, c. 371, §2 (AFF).]
B. “Cost sharing” means any coverage limit, copayment, coinsurance, deductible or other out-of-pocket expense associated with a health plan. [PL 2015, c. 371, §1 (NEW); PL 2015, c. 371, §2 (AFF).]
C. “Opioid analgesic drug product” means a drug product in the opioid analgesic drug class prescribed to treat moderate to severe pain or other conditions, whether in immediate release or extended release, long-acting form and whether or not combined with other drug substances to form a single drug product or dosage form. [PL 2015, c. 371, §1 (NEW); PL 2015, c. 371, §2 (AFF).]
[PL 2015, c. 371, §1 (NEW); PL 2015, c. 371, §2 (AFF).]
Terms Used In Maine Revised Statutes Title 24-A Sec. 4320-J
- Carrier: means :
A. See Maine Revised Statutes Title 24-A Sec. 4301-AEnrollee: means an individual who is enrolled in a health plan or a managed care plan. See Maine Revised Statutes Title 24-A Sec. 4301-A Health plan: means a plan offered or administered by a carrier that provides for the financing or delivery of health care services to persons enrolled in the plan, other than a plan that provides only accidental injury, specified disease, hospital indemnity, Medicare supplement, disability income, long-term care or other limited benefit coverage not subject to the requirements of the federal Affordable Care Act. See Maine Revised Statutes Title 24-A Sec. 4301-A
2. Required coverage. A carrier offering a health plan in this State shall provide coverage for abuse-deterrent opioid analgesic drug products listed on any formulary, preferred drug list or other list of drugs used by the carrier on a basis not less favorable than that for opioid analgesic drug products that are not abuse-deterrent and are covered by the health plan. An increase in enrollee cost sharing to achieve compliance with this section may not be implemented.
[PL 2015, c. 371, §1 (NEW); PL 2015, c. 371, §2 (AFF).]
SECTION HISTORY
PL 2015, c. 371, §1 (NEW). PL 2015, c. 371, §2 (AFF).